Active NPI
Andrew Cannon, PT, SCS
- Sports Physical Therapist
- Salem, NH
National Provider Identifier
1912144676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- License
- 4830
- Practice address
- 70 Butler Street
Salem, NH 03079 - Phone
- (603) 893-2900
- Fax
- (603) 893-1628
- NPI assigned
- Jan 15, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | 4830 | MA | Primary |
| Orthopedic Physical Therapist | 2251X0800X | 4830 | MA |
Addresses
Primary practice location
70 Butler Street
Salem, NH 03079
Mailing address
70 Butler Street
Salem, NH 03079
Phone (603) 893-2900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4830 | MA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443139200000",
"number": "1912144676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 BUTLER STREET",
"city": "SALEM",
"state": "NH",
"postal_code": "03079",
"telephone_number": "603-893-2900",
"fax_number": "603-893-1628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 BUTLER STREET",
"city": "SALEM",
"state": "NH",
"postal_code": "03079",
"telephone_number": "603-893-2900",
"fax_number": "603-893-1628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNON",
"first_name": "ANDREW",
"credential": "PT, SCS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-01-15",
"last_updated": "2015-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "MA",
"license": "4830",
"primary": true
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MA",
"license": "4830",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.